Objective To study the relationship of serum BNP level with inflammatory factors and prognosis of neonatal sepsis.Methods Fifty cases of neonatal sepsis in our hospital were selected and the level of BNP,CRP,IL-10 and TNF-α was determined with Elias method The change of these levels were observed after 12 h, 24 h and 48 h treatment.The outcome of neonatal sepsis was analyzed based on BNP level ≥150 ng/L and <150 ng/L.Results The children in BNP≥150 ng/L group had higher APACHE scores(21.36±2.68) and mortality was 34.5%(10/29),which was higher than the children with BNP<150 ng/L, the difference being statistical(P<0.05).Spearman correlation analysis showed that the BNP was positively correlated with CRP and TNF-α and negative correlation with IL-10(P<0.01).With the extension of treatment, the BNP,CRP and TNF-α levels were significantly decreased and IL-10 increased which had statistical difference compared with before treatment and 12 h and 24 h after treatment(P<0.05).Conclusion The patients with neonatal sepsis have obviously high levels of brain natriuretic peptide, which is closely related to the level of inflammatory factors and treatment length.Cardiac insufficiency may exist in these children and promote the disease progress by mediating inflammation.%目的 探讨新生儿脓毒血症的血清脑钠肽水平变化,并分析其与炎性因子C反应蛋白、白细胞介素10及肿瘤坏死因子α的关系.方法 2012年10月至2014年10月珠海市第二人民医院新生儿科收治住院的脓毒血症新生儿50例,采用Elias法检测脑钠肽、C反应蛋白、白细胞介素10及肿瘤坏死因子α水平,并观察患儿在治疗12、24、48 h后水平变化,分析脓毒血症患儿血清脑钠肽与炎性因子C反应蛋白、白细胞介素10及肿瘤坏死因子α的关系,以脑钠肽≥150 ng/L水平分两组进一步分析患儿预后情况.结果 当脑钠肽≥150 ng/L时患儿的APACHEⅡ评分为(21.36±2.68)分,死亡率达34.5%(10/29),均明显高于脑钠肽<150 ng/L患儿,差异有统计学意义(P<0.05).Spearman相关分析显示,血清脑钠肽与患儿C反应蛋白及肿瘤坏死因子α呈正相关(P<0.01),而与白细胞介素10呈负相关(P<0.01).随着治疗时间的延长,在治疗48 h后血清脑钠肽与炎性因子C反应蛋白及肿瘤坏死因子α水平明显降低,白细胞介素10水平升高,与治疗前及治疗12、24 h比较差异有统计学意义(P<0.05).结论 新生儿脓毒血症存在明显脑钠肽高水平,并与体内炎性因子水平及治疗时间均密切相关,提示患儿可能存在心功能不全并通过介导炎症反应促进疾病的发展.
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